 Hi Liam, thanks for joining us today and also your participation in the webinar we hosted in February on suicide ideation in primary school aged children. Thanks for having me. So this is a chance to really get your reflections now we're a few months after the webinar and did you have any key takeaways from the discussion? Yeah there are a couple things I've been thinking about since then I mean one of the biggest things was the level of interest so it was a really popular one of the MHPN's most popular webinars which was great and that didn't really surprise me I suppose but I felt relieved that people are taking it seriously so for a while now I've been thinking about children and suicide and and that kind of began over 10 years ago when I was working in schools so I've been reading and writing and doing some sort of research around it and I had felt concerned and then felt concerned that why aren't people worrying about this we're hearing a lot about suicide at the moment we hear a lot about youth suicide and various groups at risk but we don't hear about children so I felt relieved that people are joining me in this concern which was great. The other thing I thought about quite a lot was people anxiety around it and so people feeling like they don't know what to do so this feeling like it's something different to what I normally do I'm not necessarily able to deal with that and that came through in some of the questions on the night but also some of the questions leading up to the registration process in the webinar and something I hear about in other work that I do around this topic as well so so that I guess got me thinking about what else do we need to do and I've been writing and doing some other work as well so one of the things I did as a direct result from the webinar was to write an article for this edition of this strange psychological society in psych so it was an addition that I really was was prompted to do because of the response felt like I wanted to follow up so that's an article that's available online. Oh great and we'll put a link to that in the article alongside so folks that are watching this can check that out. Well we do have some questions that the participants provided in the exit survey and I'll get to those in a moment but one of the key takeaways from the webinar overwhelmingly participants mentioned was around collaborative approach and using you know a multi-disciplinary team to identify protective factors work closely with family members and the importance of taking the time to explain suicide risk the assessment goals and referral pathways but there's a lot there yeah yeah there's a lot and as with all of mhp and webinars with these are the sorts of issues that come up all the time so the importance of working collaboratively and the benefit we see that in the panel we see the benefit of different perspectives and different disciplines having different ways of working or sometimes some different ways of thinking about about what we're doing so doing this work you can't do it on your own really so people watching if you're sort of thinking about what the work is if you're working in a school you've obviously got people around you but they won't all necessarily be on the same page and if you're working in private practice you really need to think about well who are the people that I can consult with who are the people that I can be with what are the pathways what are those referral pathways if I am concerned how do I how do I sort of make some decisions around where to refer people so that I'm not sitting with this on my own it's really important and of course parents so my focus in the webinar was very much around role parents when we're talking about young primary school aged kids we can't think about them without thinking about parents so that was a big focus for me in the webinar and something that I'm really continuing to be interested in and doing some more writing about as well yeah great thanks Lynn and there's a link to the recording on MHPN's website as well we had a few questions for them from the participants in the exit survey so things they were sort of still reflecting on after the discussion and one of them one of the participants asked about child protection and how much they should be involved yeah I think the I think the question that came up was maybe assuming that if there's child who's suicidal that child protection is automatically needed to be a report made to child protection and I think we need to think about them as two different things so if a child discloses something as part of the conversation of which suicide is part of it and child protection your normal concerns and belief that you need to formed well then you contact child protection as part of that but suicide alibi on its own doesn't necessarily warrant a child protection report so I think it's important to distinguish those two things we do know that one of the biggest risk factors for children in relation to suicide is child abuse and you know parent issues with parents so so it may well be the case that a child protection report is required but that shouldn't be our starting point we shouldn't start with that we need we need to work through what's actually happening and go through a process to understand what's happening and then if we find that there's something of concern relation to child protection we then use our usual process but the suicide alibi in itself it's not it's not its own issue okay and someone else asked about um how about the assessment of risk was their question yeah yeah the assessment of risk of suicide is a really big one and people really struggle with it I think not just in children but across the whole board so we've had over the years we've had a lot of concern around how do we actually predict risk and we know that we can't for a whole lot of reasons we can't actually predict risk but as mental health practitioners we we need to have something that helps us to feel like we've got the information and that we can feel confident if we're living that person leave us that they're going to be we're going to be confident and so a tool can help us sometimes do that but it can actually be a very false sense of confidence so it may not actually be accurate and we know that from decades of work around that so the suicide risk assessment is much more these days around planning understanding the needs of the child and planning and safety planning is what we're really needing to focus on so understanding listening what's going on for them and how can we help them resolve some of the issues that are happening and then keep them some work on the safety planning around that which will obviously include parents and teachers in schools as well so that's that's the focus rather than getting low or medium or high risk is not helpful at all but i know it's out there people still looking at that people still have policies that talk about that so we have to really keep working on helping people understand the formulation of risk and the safety planning that comes with that yes so you mentioned tools for practitioners so and another participant asked are there any specific therapeutic interventions and how do we manage these when there are limited services available yeah and this is always an issue as well in terms of what what do we do you know we find out that there's a concern around suicide what spots our next step and of course with something like suicide for children particularly it's really understanding what's going on for them and it's often things that are happening in family or within schools or with friendships so if we sort of understand suicide and talking about suicide or acting around suicide is a way of communicating some distress that telling us that something is not right or there's something that's worrying a child well rather than thinking about what's our therapeutic approach to that our best thing is to listen take it seriously and then work with the child to understand what's actually happening for them so what's underneath this what and why is this happening now why why are we talking about suicide at this point in time and sometimes if we can work out what that is well then we we can resolve that we work with the child and work with people to to resolve the actual issue so then the talk about suicide naturally kind of dissipates or isn't needed anymore sometimes it can be part however of emerging mental health issue that may not have been picked up or a neurological issue like ADHD or autism spectrum disorder so it can be part of something else and so again that's where it warrants further assessment beyond the suicidality itself but in all sort of mental health assessment and then there might be some therapeutic treatments to do with that so it's working out what's what's underneath it what's the meaning of the suicide talk or this at the moment so another participant asked to the majority of these young children overtly express their suicide ideation suicidal ideation or is there a substantial group that don't express themselves so is the first recognition only after they have acted to self harm it might be and this this is the trouble that we have with suicide for across the board but particularly for children we have very little research around children and suicide it's it's a very difficult topic to do research on children are often not included in research for a whole lot of ethical reasons and other reasons so a lot of it we don't actually know i think it's concerning to think that if we don't sort of know the risk and we're not aware of it then children could be trying to tell us and this is what we know from the kids helpline research that children were trying to tell adults around them parents and teachers and other adults are in contact with and weren't being heard so i think and my interest in this topic is to try and raise that awareness so that adults are actually ready to hear and open to hearing so that we can see the signs and we do take it seriously so that we don't actually get children having to escalate and then act on that before people then start to say oh they were serious so i think even with adults it's very difficult people don't always tell and share their intent and we know that from research it has been conducted we know people go to gps and don't don't always share that they're suicidal feelings or thoughts or even actions so even for adults it can be very difficult for them to to tell and to share what they're actually thinking feeling and we know from adults that sometimes they had thoughts of suicide that began in childhood that they've carried with them and that they've been a constant part of their way of coping or the way of thinking about about problems and about life so we need to keep opening the doors i think and being aware and ready ready to hear and then knowing what to do if we do hear to take it seriously so we'll link to the kids helpline research thanks for mentioning that then and there's obviously a lot that got discussed on the night of the webinar and you know we can see from the practitioner comments that you know they're really engaged in the conversation another participant asked you know do you manage the case of a child that repeatedly brings up suicide and the parents feel like the child is just being attention seeking yeah i hear that a lot and it really bothers me that that we can dismiss that as attention seeking i know one of the comments that after the webinar that i read through later was someone i'm talking about working in school and being really frustrated by that and people hearing it but not really taking it seriously and that attention seeking idea that they're just saying it they just want attention so for me it's if a child's continuing to talk about it's telling us they want to hear something and it may be you know distressed or maybe something is bothering them and so they're trying to tell us and communicate with us so the more we don't take it seriously the more they can escalate that which can place them at greater risk and i think if we are thinking about a child or anyone talking about suicide as attention seeking i think we need to think about that what is it that they're needing to get our attention and why isn't that being meshed in in other ways so i think we've got to be very careful about that and i do hope that people looking at the the kids helpline research will see that this is this is quite serious and there are people that will adults as well who do have chronic suicidality who do just keep talking about it it's very difficult to work with that but they certainly need additional support and that is something that psychologists and other mental health practitioners do to help people to to work with but even then even if people it's very common for people you're looking for changes in that so you're looking at if that kind of escalates or if there's a change in that because it can still be at risk even if they're talking about it seems quite normal so we do need to take it seriously particularly children because there's a lot of concern if they're talking about that to other children that can be concerning it becomes part of who they are it becomes a kind of a way of talking about feelings when we should be helping them i've been up their conversation and i've been up and find other ways of expressing themselves as well and not impacting on other kids too yeah so was there anything that you didn't get to share on the night lin of the webinar there was yeah there's always lots more the time goes really really quickly and you feel like you've got a lot of information but there's always more to to share and more that comes up i think there are a couple of things one of the areas i guess that for me and children is around teachers and schools being aware and certainly even when i worked school psychologists which is over 10 years ago when i was working in schools it was starting to emerge then and i remember in primary schools people being really concerned and not not really ready for that it was something that they thought older kids would talk about so it was often quite difficult for teachers to hear that and of course teachers aren't trained in mental health they're part of it and they're a very important part of mental health and well-being of children but it can be very difficult for mental health practitioners who have some training to deal with children who are or respond effectively and be sensitive to children who are who are suicidal or talking about suicide for civil teachers it's even harder so i think helping teachers and supporting teachers is something that we need to do more of and i know there's initiatives like BU that are out there to help teachers to keep working through this and have it as part of their overall work that they do but i do think in terms of suicide risk it is really important to to make sure that we are supporting teachers who are hearing this and exposed to this it can be really confronting and difficult to hear and the other part of that is self-care for all of the adults and and workers who are working with with children and families at risk of suicide and i do some consultation with people in relation to suicide risk and you see the impact on people it really the weight of it sits with people and often mental health practitioners haven't had specific training in suicide and there's various courses and things that are that are there professional development events and things like the webinar but sitting with it is really hard and again that self-care that that ability to feel like you've done as much as you can that you've had support and that you're actually able to look after yourself and that you're using this as a chance to reflect on what you can do and the the capacity that people have to get through difficult times i think is really important as well so that notion of self-care and sitting with with what this means i think is really important one and helping people find opportunities to do that yeah and that's really important with um it's it's suicide prevention day today and are you okay days is coming up so having you know keeping an eye on your colleagues and those in the community you mentioned teachers are such an important part of the conversation as well yeah well given it is world suicide prevention day what's your advice to practitioners yeah that the theme this year is shine a light on suicide prevention so i guess that's what we did this webinar i did get a shiny on children and the risk of suicide so i think that's self-care message i think continuing to find out about it so engaging in conversations about it i think trying to understand it as part of the work that we do it's not something that you come across and then you have to refer out there's a lot of things that people can do through their listening skills through their their basic core skills as a health practitioner and that you can do that will be really helpful because if you don't have that in place all the strategies and all the all the tools in the world i'm going to make a difference so trust in yourself get support in yourself and look after yourself but engage and and keep learning about it i think it's very important great advice lean and we hear that you attended a conference recently or perhaps a couple of conferences you've been pretty busy pretty busy so since since the webinar i've been to a couple of conferences i went to the suicide prevention australia conference and i did present about this topic i just had a 15 minute slot and in the audience were the researchers from boys town who did the kids helpline so they came up to me that research they came up to me afterwards and said that they were pleased and i'd shared that so i think they're happy with what i shared i don't think i misrepresented it too badly so that was a nice connection to make so that was great and then i did a workshop at the 20th international mental health conference which was up on the gold coast which is very nice it's um at the um golf resort up there not that i got outside very often but it was it was nice to be there and i had a workshop and it was an hour and a half workshop and that was really popular i had we were turning people away at the door so we had capacity in the room for about 75 people and people were lining up the door so i know the interest is there which is which is fabulous and i'm heading off to the um congress the 30th international congress in um dairy in all the island in um for that period of time september as well so i'll be heading heading off there right and i've got a poster about this topic as well excellent well hopefully a bit of self-care time yes holiday that sounds great and um we also hear that you've got a book coming out yes so i spent last year writing a book for parents so it was built on in many ways it's it's my life's work so the work that i've done with parents work i've done communities and then my more recent focus explicit focus on suicidology so i've pulled all that together and it's a pair a book for parents of teenagers called keeping our kids alive parenting suicidal teenagers so that's going to be coming out it's going to be published by Australian academic press and it's with copy editor apparently so fixing up all of my little typos and grammatical errors that is a few of um and it should be out later in the year and i'm working on a similar version for parents of younger children now so that's my little project at the moment so hopefully they'll come out next year yeah and one for practitioners to look out for yes yes hope it's useful yeah well thank you so much for your time today lean it was just great to reflect and hear your thoughts post webinar and also just get your thoughts on some of the practitioner questions so i hope that some of the practitioners that we answer their questions hopefully they're watching this along today um well we can announce that next year early 2020 we're looking at continuing this discussion um an mhp and a place to announce that we'll be hosting a webinar focused on suicide risk assessment which you're going to be a part of lean you're helping us yes yes looking forward to that so thank you it'll be another interdisciplinary panel discussion so look out for that and um check out mhpn.org.au for all of the details and keep up with our upcoming webinars and of course our practitioner networks but thanks again lean great to chat with you today great to be here thanks